Wellness and Epilepsy:
Taking care of yourself
URMI VAIDYA-MATHUR, LCSW
Topics we will cover
 Common themes for individuals living with chronic




illness
The basic steps to caring for yourself
Managing your stress
Relaxation Techniques
Programs available through NEREG
Impact of Living with Chronic Illness
 See a period of adjustment that can be emotional
 See a potential increase in depression and anxiety





like symptoms short term
For some we see depression/anxiety long term
Increase in stress overall
Sense of loss of “invincibility”
Sense of loss of independence
Initially a decrease in one’s quality of life
Our hope…
 Our hope is that we can conquer all of these negative
impacts and that patients and their families, with a
few lifestyle changes, can have their quality of life
back…and even in some cases things end up better
because of the positive changes that the illness
brought about.
“The Basics:
 Treatment Adherence: apptmts and medication
 Know your medications
 Medical Alert Bracelet
 Safety Plan
 Eat Right
 Exercise
 Get enough sleep
 No Drugs/No Alcohol
What about the more abstract ways you can care for yourself?
 Stress management
 Dealing with depression
 Relaxation Techniques
 Connecting with the community at large
Stress Management
 It may seem that there is nothing you can do about
stress. But you have more control than you might
think. In fact, the simple realization that you are in
control of your life is the foundation of stress
management!
 Managing stress is all about taking charge: of your
thoughts, emotions, schedule and the way you deal
with problems
Identify the sources of stress in your life.
 This is not as easy as it sounds, sources of stress are
not always obvious and it is easy to overlook your
own stress-inducing thoughts, feelings and
behaviors.
 Do you explain stress away as temporary?
 Do you define stress as an integral part of your work
or home life?
 Do you define stress as part of your personality?
 Do you blame stress on other people or outside
events?
 Do you view stress as entirely normal and
unexceptional?
The four As
 Until you accept responsibility for the role you play
in creating or maintaining stress, your stress level
will remain outside of your control.
“Avoiding” the Stressor
 Learn how to say “no”
 Avoid people who stress you out
 Take control of your environment
 Avoid hot button topics
 Pare down your “to do” list
“Alter” the situation
 Express your feelings
 Be willing to compromise
 Be more assertive
 Manage your time better
“Adapt” to the stressor
 Reframe the problems
 Look at the big picture
 Adjust your standards
 Focus on the positive
“Accept” things you can not change
 Don’t try to control the uncontrollable
 Look for the upside
 Share your feelings
 Learn to forgive
Dealing with Depression
 Over 80% of those treated with depression improve
 Depression can affect people of all ages, races, SES
and genders.
 Nearly half of all depressed people do not receive the
appropriate treatment because they are not correctly
diagnosed
 Severe depression is associated with a decline in
mental function as time passes
What are some symptoms of depression?
 Depressed mood almost all day long
 Reduced interest in activities/people
 Weight changes (5% in one month)
 Insomnia/hypersomnia
 Motor retardation or activation
 Fatigue
 Guilt or low self worth
 Concentration problems
 Suicidal thoughts or acts
Treatments for depression
 Prescription medication
 Talk therapy with a psychotherapist
 Close monitoring be an epileptologist especially if
there is a connection between epilepsy and mood
 Family therapy and psycho-education
 Vagal Nerve Stimulator
 For refractory depression: Electroshock (ECT) or
transcranial magnetic stimulation (TMS)
Behavioral interventions to help with depression
 Monitoring thoughts and feelings
 Using relaxation techniques
 Mindfulness based treatment
How can we monitor our thoughts?
 Sit quietly…
 What are you feeling? Breathing, posture, physical
feelings, emotions?
 Feeling words: afraid, nervous, insecure, uneasy,
worried, out of it, shaky, uptight?
 What are you thinking? What just happened before
the feeling, how does this affect future?
 What am I upset about?
 What’s the worst that could happen?
 How might this affect me?
 How would this affect how others see me?
 Does this remind me of my past?
 What would my parents say about this?
 How does this affect how I see myself?
 Have I thought this before? Did it come true?
 Do I have experiences that contradict this?
 Is this as awful as I am imagining?
 A year from now, how important will this be?
 Do I know anyone who dealt with this effectively?
Can someone help me?
 Be your own buddy: talk to yourself calmly like a
friend would
 Take the negative thought and come up with an
opposite/positive thought
RELAXATION TECHNIQUES
 There are many forms of relaxation that one can
practice:
•
•
•
•
Yoga
Meditation
Exercise
Mindfulness
Progressive Muscle Relaxation (PMR)
Step One: Tension.
The process of applying tension to a muscle is essentially the
same regardless of which muscle group you are using.
First, focus your mind on the muscle group; for example, your
right hand. Then inhale and simply squeeze the muscles as hard
as you can for about 8 seconds (e.g., make a tight fist with your
hand).
PMR
Step Two: Releasing the Tension.
This is the best part because it is actually pleasurable. After
the 8 seconds, just quickly and suddenly let go.
Let all the tightness and pain flow out of the muscles as you
simultaneously exhale.
Feel the muscles relax and become loose and limp, tension
flowing away like water out of a faucet. Focus on and notice
the difference between tension and relaxation.
PMR
 Muscle Groups
Right foot
 Right lower leg and foot
 Entire right leg
 Left foot
 Left lower leg and foot
 Entire left leg
 Right hand
 Right forearm and hand

PMR








Entire right arm
Left hand
Left forearm and hand
Entire left arm
Abdomen
Chest
Neck and shoulders
Face
Mindfulness Based Cognitive Therapy
 Mindfulness Based Cognitive Therapy (MBCT)
mindfulness and mindfulness medication focus on
becoming aware of all incoming thoughts and
feelings and accepting them, but NOT attaching a
feeling to them nor reacting to them
The Goal of MBCT
 The goal is to interrupt the automatic reactions one
has to experiences and to teach participants to focus
LESS on reacting to the incoming stimuli and instead
to accept and observe them without judgment
The three “C”s
Catch
You want to be able to catch the negative thought that has entered
your mind.
You want to stop and be aware of the thought
Check
You want to check the thought, is it positive or
negative? Can you prove or disprove the thought.
Correct
Once you have “caught” the thought and spent a
moment to “check” your response or feelings to the
thought/stimuli you want to then modify the way
you identify the thought based on the present
moment not your past experiences nor your past
reactions.
Project UpLift
 NEREG offers a distance based 8 week course to help
build the skills needed to combat depression with
mindfullness.
 For more information contact:
uvmlcsw@gmail.com
Get Connected
 Joining support groups, online or in person, are
found to be helpful in promoting wellness and
support among those with chronic illness
 Volunteer with local organizations that work with
people with epilepsy
 Take advantage of the wellness programs offered at
NEREG through www.epilepsylifelinks.com
Thank you!
 For more information please feel free to contact me:
• Urmi Vaidya-Mathur, LCSW
• uvmlcsw@gmail.com